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Wang Y, Chen S, Feng S, Wang C, Jiang H, Rong S, Hermann H, Chen J, Zhang P. Telomere shortening in patients on long-term hemodialysis. Chronic Dis Transl Med 2021; 7:266-275. [PMID: 34786545 PMCID: PMC8579019 DOI: 10.1016/j.cdtm.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 01/14/2023] Open
Abstract
Background Leukocyte telomere length shortening is a characteristic of premature senescence, a process that can be accelerated by oxidative stress. In general, patients with end-stage renal disease undergoing regular hemodialysis (HD) are repeatedly exposed to oxidative stress. Patients undergoing HD tend to have cardiovascular diseases associated with oxidative stress and inflammation. Therefore, we assumed that telomere length is associated with HD vintage and the degree of vascular calcification. Methods A total of 144 patients undergoing regular HD before kidney transplantation and 62 patients on hemodialysis, but not undergoing kidney transplantation, were enrolled. We measured common laboratory values, such as calcium, phosphate, and hemoglobin levels, and assessed the degree of vascular calcification in the patients. The leukocyte telomere length was measured using reverse transcription polymerase chain reaction, and Spearman correlation was used for correlation analysis. Results The leukocyte telomere length was negatively associated with age (rho = −0.306, P<0.01); it was shorter in middle-aged patients than in young patients (13.48 ± 4.80 vs. 15.86 ± 4.51, P < 0.01). The telomere length was significantly different among patients aged 52–74 years in groups with different HD vintages. Additionally, the telomere length was positively associated with serum hemoglobin (Hb) levels in all patients (rho = 0.290, P < 0.01). There was a significant difference among patients divided into three groups according to the degree of anemia (17.09 ± 5.64 vs. 14.40 ± 4.07 vs. 13.99 ± 3.95, P < 0.01). Further, a significant difference was observed in the telomere length among patients with different degrees of vascular calcification (16.79 ± 4.91 vs. 13.61 ± 2.82 vs. 14.62 ± 3.63 vs. 10.71 ± 3.74, P < 0.01). The telomere length was shorter in the patients on hemodialysis who did not receive a kidney transplant than in the surgical patients (8.12 ± 1.83 vs. 14.33 ± 4.63, P < 0.01). Conclusion This study demonstrated that the telomere length was significantly correlated with HD vintage in patients of a certain age group. The telomere length was shorter in patients on hemodialysis who matched for age and dialysis vintage with kidney transplant patients. It was also associated with vascular calcification and serum Hb levels in all patients undergoing HD.
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Affiliation(s)
- Yucheng Wang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Siyu Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Shi Feng
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Cuili Wang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Hong Jiang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Song Rong
- Clinic for Kidney and Hypertension Diseases, Hannover Medical School, Lower Saxony, 30625, Germany
| | - Haller Hermann
- Clinic for Kidney and Hypertension Diseases, Hannover Medical School, Lower Saxony, 30625, Germany
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Corresponding author. Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, Zhejiang, 310003, China.
| | - Ping Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China
- Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China
- Corresponding author. Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, Zhejiang, 310003, China.
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El-Metwally TH, Hamed EA, Ahmad AR, Mohamed NA. Dyslipidemia, oxidative stress and cardiac dysfunction in children with chronic renal failure: effects of L-carnitine supplementation. Ann Saudi Med 2003; 23:270-7. [PMID: 16868393 DOI: 10.5144/0256-4947.2003.270] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Secondary carnitine deficiency may develop in chronic renal failure (CRF) patients undergoing long-term hemodialysis (HD), with a resulting higher incidence of cardiovascular diseases, dyslipidemia and oxidative stress. We studied the efficacy of 12 months of L-carnitine supplementation on the amelioration of dyslipidemia, oxidative stress and cardiac dysfunction in 24 CRF children undergoing long-term HD compared with 24 age- and sex-matched controls. METHODS Plasma samples were analyzed spectrophotometerically before and after dialysis sessions and after 2-month supplementation with oral L-carnitine (50 mg/kg/day) for free carnitine (FC), the lipid profile, and oxidative stress markers. Echocardiography the day following dialysis measured cardiac diameters, wall thicknesses, left ventricular mass index (MI), end diastole and systole volume indices and functions. RESULTS The pre-dialysis FC concentration was substantially lower than controls and decreased significantly at the end of the dialysis session. Pre- and post-dialysis plasma levels of free fatty acids (FFAs), trigyleride (TG), total cholesterol (TC) and oxidative stress markers significantly increased while high-density lipoprotein cholesterol (HDL-C) and phospholipids significantly decreased compared to controls. Echocardiography detected a significant increase in cardiac diameters and thickness, and systolic and diastolic cardiac dysfunction. After L-carnitine supplementation, plasma levels of FC increased to normal levels. FFAs, TC and HDL-C returned to control levels while TG, phospholipids, and the oxidative stress markers decreased but remained significantly higher than controls. There was a significant decrease in cardiac diameters and an increase in left ventricular diastolic function (E/A ratio), but no correlation between FC levels and echocardiographic parameters. Pre-dialysis, post-dialysis and after treatment, plasma FC level showed a significant positive correlation with HDL-C and phospholipids and a significant negative correlation with each of oxidative stress markers, FFAs, TG and TC. On the other hand, FFAs showed a significant positive correlation with TG, TC, DC, NO and a significant negative correlation with HDL-C and phospholipids. CONCLUSION This study demonstrates that CRF children under regular HD suffer from a decrease in the level of plasma FC, dyslipidemia, oxidative stress, and an increase in cardiac diameters and thickness with impairment of cardiac functions. Oral L-carnitine supplementation at a dose of 50 mg/kg for 2 months can increase plasma FC level, improve dyslipidemia, decrease oxidative stress with reduction of cardiac diameters and increase in diastolic function.
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Affiliation(s)
- Tarek H El-Metwally
- Department of Biochemistry, Physiology and Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
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